Health: Rethinking Remedies for Colds and Coughs

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October 1, 2007, 6:49 am

 

Rethinking Remedies for Colds and Coughs

 

A panel of safety experts at the Food and Drug Administration has proposed

banning over-the-counter cough and cold medicines for kids under age 6.

There's growing concern about the health risks and little evidence that the

remedies work in young children.

 

But guess what? Cough medicines usually don't work for grown-ups, either. The

American College of Chest Physicians last year issued new guidelines for

treating coughs, and concluded that many popular medications simply don't

quiet coughs caused by the common cold. In particular, the group concluded

that the drug guaifenesin — an expectorant found in such popular brands as

Robitussin and Mucinex — doesn't calm coughs due to colds. Neither do two

suppressants, codeine and dextromethorphan, though they may help coughs due

to causes other than colds.

 

Drug makers have long defended their products by noting that an F.D.A.

review a decade ago concluded the ingredients were safe and effective. They

say people wouldn't buy cough medicines if they didn't work. In cough

studies, however, as many as 40 percent of patients taking placebos report

improvement, the chest doctors noted.

 

An industry trade group last week urged the F.D.A. to consider warning

labels saying that cough medicines should not be given to children younger

than 2. But according to the college's guidelines, over-the-counter cough

and cold remedies shouldn't be used by kids under age 14.

 

Dr. Barney Softness, a New York pediatrician, says he has long warned

parents that cough and cold medicines are likely to do more harm than good.

Side effects can include palpitations, headaches, dizziness, anxiousness and

hyperactivity. " Just like too much coffee,'' says Dr. Softness. " It's just

more pathetic in infants and toddlers.'' An even bigger concern is that some

over-the-counter cold drugs can make asthma symptoms worse, says Dr.

Softness.

 

So what do you do to quiet a cough? For adults, the American College of

Chest Physicians recommends old-line antihistamines that aren't even

marketed as cough drugs, including diphenhydramine, the active ingredient in

Benadryl; dexbrompheniramine, an active ingredient in Drixoral; and

chlorpheniramine, the active ingredient in Chlor-Trimeton. The downside is

that the drugs can make you drowsy. They can also worsen prostate problems

in men. Pain relievers such as naproxen and ibuprofen also may help patients

with coughs caused by the common cold. But they can also cause stomach upset

or increase the risk of gastrointestinal bleeding.

 

For kids, there are fewer options, but cough is " ultimately not as harmful

as people think,'' said Dr. Softness. " Warm humid air, honey, and yes,

chicken soup work as well as anything.''

 

Copyright 2007 The New York Times Company